21612 78TH AVE W.PDFIIIIIIIIIIII
6662
21612 78TH AVE W
CITY
S
PUBLIC WORKS DEPART*
FOR INSPECTION CALL IS Permit 11.0
775-2525 Ext. 220 Issue Date
P4
P4
4
�H
co
E-4
P4
2:
0
U
0
E-4
SIDE SEWER PERMIT
PERMIT MUST BE POSTED ON JOB SITE
l.. Address.of -Construction
2. Property Legal Description (include all. easements)
1 19,4,
3. Single Family Residence Nfulti-Family No. of Units
Commercial
4. Owner and/or Builder &g2r
g,KT
4, �4# '144
5. Contractor & License No. Awr.a
f-
;��T
6. Invasion into City Right -of -Way: No Yes (If Yes f-
way Construction Permit Required - Call Dial Dig (342-5,344) be ore
excavation).
7. Cross other private property: Yes No Easement required -
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
a. Property owners must obtain a permit to instdll side sewers on
,their property. A licensed side sewer contractor must be employed to
construct side sewers in the public' right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year.
C. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
d. Side sewers may not be installed closer than thirty inches (30")
to any structure. 0
e. Side sewer lines must be laid at a minimum grade. of 2% (1.15
and maximum grade of 100% (450). 0
f. No turn in side s8wer greater than 45 (1/8,bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a'45 (1/8
bend).and wye with removable cap.
g. No down spouts, footing drains or floor�-drains can be connected
to side sewer system.
h. Pea gravel is require d for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30'1-60" from each plumbing exit line
and at minimum intervals of 1001 along sewer 'line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer,must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2)!working
days notice required. It'
DATE: , 7- 9;--2 1A.AwA-4.L.�
1-16e:ftify /that I ha
11 h j
_,.,PERMIT FEE:,,,,
Cd ()PC I f,
P4 NNECT 1 9 N
wa Wj -rMj'A- M FA
PERMIT
.and�shayl comply Wi hove
DISAPPROVED BY: Date:
B Date: -Z�70 9:5v
APPROVED By Date: 7
.11 -01
BE POSTED ON JOB,SITE *
y Of Edmonds
/v�
for
SIME SEWER PEILBUT
UtM82DE X INSIDE 0
LC
REPAIRS 0
CARD No. ...............
.......... .......
EASEMENT No . ......................................
. ...................
OvM CONTRACTOR
............. ..... .............
............ PEPLVaT No . ... .. .... ... ...
STREET
HOUSE. . . . ...... ..................................... AVENUE LOT No . ......
N( ...................... BLOCK No . ...............................................
2-'�� #70 NAME ADDA-1 A.111.211 .....
7c;
7-
BACKFUJ, WORK ORDER ISSUED ..............
............. . ...... DEPOSIT,
SEWER WORK ORDER ISSUED
Approved:-
D, .. .. BY ........
�11GE]R
FLI 14 TI 3 L j0f4
_ 7�tTLA T
APPROVED
FEB 142 1964,
41
Side, Sewer Drawing,
The City of EdmondsZ.,,, EASEMENT NO . ............................................
)'Mum..
NEW CONSTRUCTION jZ(/'- REPAIRS F] LID NO . .................. . ASMT. NO . ...................
OWNER -14 CONTRACTOR ........ ..... PERMIT NO. Z-,� . ............
.,q
. .. ........ . . . ..... n
..................
JOB ADDRESS ....... 4--f LEGAL DESCRIPTION: LOT NO . ..... ................................. BLOCK NO . ....................................
--- ........
.......... clo.e'L-P/
.................
.......... A�.'S:a a �-*
0
0
PWW-0001-11175 (REV,.11178)
NAMEOF ADDITION ........................................................................................................................
EVIA BALLINGER
LIFT STATION
78 z4v-e-. ukJ
Approved:
DATE
0
B
.y . .....
V
NOTICE:
No warranty of accuracy.
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City ofEdmonds does -,.not warrant the
accuracy of anything set forth on these
map(s). Any person or entity requesting a
copy should conduct an independent
inquiry regarding the information shown on
the rnap(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
empl-oyees or officers shall be lia-b-le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS
PU0BLIC KIRM — ENGINEERIWG
ACTION REPORT
=mob
N9 5634
STNEET RLE
SUSPENSE DATE:
Date: Time: File #
Attachments: =Yes
REQUESTOR: NAME: neeo
ADDRESS: '2- lr�4p 1 7
PHONE: 6 flom e-
REQUEST RECEIVED BY:- 7 (ofs
TELEPHGNE
CONTACT IN OFFICE r---j
OTHER: r--7
RECEIVED BY: O��
R011TF Tn-
gam
i-D
NMMMZI
All Concerned Notified
Action Completed/File